UTMB Pharm Exam 1 UPDATED ACTUAL
Exam Questions and CORRECT Answers
Acute Inflammation - CORRECT ANSWER - initial response of increased plasma and
leukocytes from blood to site of injury
Chronic Inflammation - CORRECT ANSWER - progressive shift in type of cells present at
the site and simultaneous destruction + healting of tissue
Autoimmune - CORRECT ANSWER - inability to distinguish self from non-self,
progressive tissue injury > pain, loss of function, disability, decreased quality of life
Misoprostol - CORRECT ANSWER - Action: Mucosal lining of stomach, Reduces gastric
acid production in chronic NSAID use
Uses: Prevention of gastric ulcers chronic NSAID use
SE: diarrhea, cramping
ABORTIFACIENT!-Black Box
Latano-/Travo-/Bimato- PROST - CORRECT ANSWER - A prostaglandin
Action: increase uveoscleral outflow
(Bimatoprost for eyelash growth/pigmentation)
Use: open angle glaucoma, elevated intraocular pressure (ophthalmic soln)
Epoprostenol
Illoprost - CORRECT ANSWER - Action: potent pulmonary vasodilator
Use: Pulmonary Arterial HTN (PAH)
Form: continuous IV infusion due to short half life, nebulizer
Side effect (Illoprost): Dizziness, Flushing, Headache, fainting (syncope)
,Aloprostadil - CORRECT ANSWER - A Prostaglandins
Action: smooth muscle relaxation
Use: Erectile dysfunction, patency of neonate ductus arteriosus
Lubiprostone - CORRECT ANSWER - Action: increase intestinal fluid secretion
Use: Chronic constipation, IBS
SE: nausea, diarrhea
NSAIDs - CORRECT ANSWER - Action: ALL NSAIDS act by inhibiting cyclooxygenase
enzymes resulting in decreased PROSTaglandin synthesis --> inactivate COX
SE: CV events (thrombosis, MI, stroke), GI events(bleeding, ulceration, perforation), renal
toxicity
COX-1 vs. COX-2 - CORRECT ANSWER - diffences in safety and efficacy depend on
the balance of COX-1 vs. COX-2
COX-1 inhibition - CORRECT ANSWER - Prevention of CV events, most adverse
events(like stomach ulcers and gastric bleeding; less platelet aggregation)
COX-2 inhibition - CORRECT ANSWER - anti-inflammatory and analgesia
Metabolism of ASA - CORRECT ANSWER - irreversibly acetylates (inactivates COX)
becomes salicylate
3 Actions of ASA - CORRECT ANSWER - anti-inflammatory
antiPyretic
Analgesic
,Acetylsalicylic acid (ASA aka Aspirin) - CORRECT ANSWER - NSAID prototype
(approved by FDA in 1939)
Action: irreversibly inactivates cyclooxygenase(unique)
Uses:
Topical-->acne, corns, calluses, and warts
Inhibits platelet aggregation --> irreversibly inhibits Thromboxane(COX-1 path) for 3-7days (life
of the platelet)
Decreases vasoconstriction
Reduces risk of: TIAs(storke;low dose); MI sudden death, unstable angina; CV risk in
revascularization procedures
ASA Pharmacokinetics - CORRECT ANSWER - Oral administration: salicylates passively
absorbed in stomach and small intestine
Rectal absorption is slow and urliable
Must be avoided in children and teenagers (<20) with viral infections, to prevent Reyes
syndrome
ASA Dosages - CORRECT ANSWER - Analgesic activity-->low doses( 2 35mg ASA QID
=8 tablets)
Anti-inflammatory-->higher doses (12-20 tablets/day; w/RA)
Long-term MI prophylaxis (81-162mg/day)
Acute MI--> 162-325mg non-EC(chewed)
Stroke prophylaxis-->50-325mg/day
ASA side effects - CORRECT ANSWER - N/V, epigastric pain, microcopic bleeding
(occult)-->take with food
Avoid one week prior to surgery(anti-platelet)
Toxic doses: respiratory depression, metabolic acidosis, and hyperthermia
Approximately 15%-->HTN rxn
Reye syndrome (pedi, viral illness)
, Pregnancy category C(1 and 2 trimesters), catagory D (3rd); excreted in breastmilk-avoid if
breastfeeding
ASA toxicity - CORRECT ANSWER - Mild (salicylism) = N/V, hyperventilation,
headache, confusion, dizziness, TINNITUS(ringing)
Severe with large doses: restlessness, delirium, hallucinations, convulsions, coma, respiratory
and metabolic acidosis, respiratory failure and DEATH
-monitor serum slicylate concentrations and pH
-increased urine pH enhances elimination of salicylate
-Tx: IVF, dialysis may be needed, correction of electrolyte imblances
Children prone to salicylate intoxication (as little as 10mg can cause death)
Drug interactions with ASA - CORRECT ANSWER - Hemorrhage-->Heparin
Decreased urate excretion-->Probenecid, Sulfinpyrozone
Increasese plasma concentration leading to prolonged half-lives, therapeutic effects, and toxicity
-Bilirubin
-Phenytoin
-Valproic acid
-Sulfinpyrazone
-Thiopental
-Thyroxine
-Triiodothyronine
ASA Overdose - CORRECT ANSWER - -mainly see in children/elderly
-maintain ABC's(airway, breathing, circulation)
-activated charcoal
-alkalinize urine with Sodium bicarb
Exam Questions and CORRECT Answers
Acute Inflammation - CORRECT ANSWER - initial response of increased plasma and
leukocytes from blood to site of injury
Chronic Inflammation - CORRECT ANSWER - progressive shift in type of cells present at
the site and simultaneous destruction + healting of tissue
Autoimmune - CORRECT ANSWER - inability to distinguish self from non-self,
progressive tissue injury > pain, loss of function, disability, decreased quality of life
Misoprostol - CORRECT ANSWER - Action: Mucosal lining of stomach, Reduces gastric
acid production in chronic NSAID use
Uses: Prevention of gastric ulcers chronic NSAID use
SE: diarrhea, cramping
ABORTIFACIENT!-Black Box
Latano-/Travo-/Bimato- PROST - CORRECT ANSWER - A prostaglandin
Action: increase uveoscleral outflow
(Bimatoprost for eyelash growth/pigmentation)
Use: open angle glaucoma, elevated intraocular pressure (ophthalmic soln)
Epoprostenol
Illoprost - CORRECT ANSWER - Action: potent pulmonary vasodilator
Use: Pulmonary Arterial HTN (PAH)
Form: continuous IV infusion due to short half life, nebulizer
Side effect (Illoprost): Dizziness, Flushing, Headache, fainting (syncope)
,Aloprostadil - CORRECT ANSWER - A Prostaglandins
Action: smooth muscle relaxation
Use: Erectile dysfunction, patency of neonate ductus arteriosus
Lubiprostone - CORRECT ANSWER - Action: increase intestinal fluid secretion
Use: Chronic constipation, IBS
SE: nausea, diarrhea
NSAIDs - CORRECT ANSWER - Action: ALL NSAIDS act by inhibiting cyclooxygenase
enzymes resulting in decreased PROSTaglandin synthesis --> inactivate COX
SE: CV events (thrombosis, MI, stroke), GI events(bleeding, ulceration, perforation), renal
toxicity
COX-1 vs. COX-2 - CORRECT ANSWER - diffences in safety and efficacy depend on
the balance of COX-1 vs. COX-2
COX-1 inhibition - CORRECT ANSWER - Prevention of CV events, most adverse
events(like stomach ulcers and gastric bleeding; less platelet aggregation)
COX-2 inhibition - CORRECT ANSWER - anti-inflammatory and analgesia
Metabolism of ASA - CORRECT ANSWER - irreversibly acetylates (inactivates COX)
becomes salicylate
3 Actions of ASA - CORRECT ANSWER - anti-inflammatory
antiPyretic
Analgesic
,Acetylsalicylic acid (ASA aka Aspirin) - CORRECT ANSWER - NSAID prototype
(approved by FDA in 1939)
Action: irreversibly inactivates cyclooxygenase(unique)
Uses:
Topical-->acne, corns, calluses, and warts
Inhibits platelet aggregation --> irreversibly inhibits Thromboxane(COX-1 path) for 3-7days (life
of the platelet)
Decreases vasoconstriction
Reduces risk of: TIAs(storke;low dose); MI sudden death, unstable angina; CV risk in
revascularization procedures
ASA Pharmacokinetics - CORRECT ANSWER - Oral administration: salicylates passively
absorbed in stomach and small intestine
Rectal absorption is slow and urliable
Must be avoided in children and teenagers (<20) with viral infections, to prevent Reyes
syndrome
ASA Dosages - CORRECT ANSWER - Analgesic activity-->low doses( 2 35mg ASA QID
=8 tablets)
Anti-inflammatory-->higher doses (12-20 tablets/day; w/RA)
Long-term MI prophylaxis (81-162mg/day)
Acute MI--> 162-325mg non-EC(chewed)
Stroke prophylaxis-->50-325mg/day
ASA side effects - CORRECT ANSWER - N/V, epigastric pain, microcopic bleeding
(occult)-->take with food
Avoid one week prior to surgery(anti-platelet)
Toxic doses: respiratory depression, metabolic acidosis, and hyperthermia
Approximately 15%-->HTN rxn
Reye syndrome (pedi, viral illness)
, Pregnancy category C(1 and 2 trimesters), catagory D (3rd); excreted in breastmilk-avoid if
breastfeeding
ASA toxicity - CORRECT ANSWER - Mild (salicylism) = N/V, hyperventilation,
headache, confusion, dizziness, TINNITUS(ringing)
Severe with large doses: restlessness, delirium, hallucinations, convulsions, coma, respiratory
and metabolic acidosis, respiratory failure and DEATH
-monitor serum slicylate concentrations and pH
-increased urine pH enhances elimination of salicylate
-Tx: IVF, dialysis may be needed, correction of electrolyte imblances
Children prone to salicylate intoxication (as little as 10mg can cause death)
Drug interactions with ASA - CORRECT ANSWER - Hemorrhage-->Heparin
Decreased urate excretion-->Probenecid, Sulfinpyrozone
Increasese plasma concentration leading to prolonged half-lives, therapeutic effects, and toxicity
-Bilirubin
-Phenytoin
-Valproic acid
-Sulfinpyrazone
-Thiopental
-Thyroxine
-Triiodothyronine
ASA Overdose - CORRECT ANSWER - -mainly see in children/elderly
-maintain ABC's(airway, breathing, circulation)
-activated charcoal
-alkalinize urine with Sodium bicarb
